Assessing Blood Supply to a Peripheral Portion of an Animal

• US 20100016733A1
• Filed: 02/15/2007
• Published: 01/21/2010
• Est. Priority Date: 02/15/2006
• Status: Abandoned Application

• Current Assignee: Dialog Devices Limited
• Original Assignee: Dialog Devices Limited
• Inventors: Smith, Peter Richard, Crabtree, Vincent
• Application Number:
  US12/223,757
• Publication Number:
  US 20100016733A1
• Time in Patent Office: Days
• US Class Current: 600/483
• CPC Class Codes: A61B 5/01 Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/0261 using optical means, e.g. infrared light
• CPC Class Codes: A61B 5/0295 using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
• CPC Class Codes: A61B 5/6829 Foot or ankle

Abstract

A post-operative, arterial patency monitoring system for monitoring patency of an artery of a limb including: a first probe positioned adjacent a first tissue area of a limb for producing first output signals dependent upon a first arterial blood supply to the first tissue area; a second probe positioned adjacent a second different tissue area of the limb for producing second, different output signals dependent upon a second arterial blood supply to the second tissue area; and means for processing the first output signals to produce a first arterial blood supply metric for the first arterial blood supply and a second, different, arterial blood supply metric for the first arterial blood supply; means for processing the second output signals to produce the first arterial blood supply metric for the second arterial blood supply and the second arterial blood supply metric for the second arterial blood supply; means for using a predetermined function that takes as its arguments at least the first and second arterial blood supply metrics for the first arterial blood supply to produce a combined arterial patency metric for the first blood supply; means for using the predetermined function that takes as its arguments at least the first and second arterial blood supply metrics for the second arterial blood supply to produce a combined arterial patency metric for the second arterial blood supply; means for comparing the combined arterial patency metric for the first arterial blood supply with the combined arterial patency metric for the second arterial blood supply; and means for determining the patency of a first artery that provides the first arterial blood supply using a difference between the combined arterial patency metric for the first arterial blood supply and the combined arterial patency metric for the second arterial blood supply.

Claims

1. A post-operative, arterial patency monitoring system for monitoring patency of an artery of a limb comprising:

a first probe positioned adjacent a first tissue area of a limb for producing first output signals dependent upon a first arterial blood supply to the first tissue area;

a second probe positioned adjacent a second different tissue area of the limb for producing second, different output signals dependent upon a second arterial blood supply to the second tissue area; and

means for processing the first output signals to produce a first arterial blood supply metric for the first arterial blood supply and a second, different, arterial blood supply metric for the first arterial blood supply;

means for processing the second output signals to produce the first arterial blood supply metric for the second arterial blood supply and the second arterial blood supply metric for the second arterial blood supply;

means for using a predetermined function that takes as its arguments at least the first and second arterial blood supply metrics for the first arterial blood supply to produce a combined arterial patency metric for the first blood supply;

means for using the predetermined function that takes as its arguments at least the first and second arterial blood supply metrics for the second arterial blood supply to produce a combined arterial patency metric for the second arterial blood supply;

means for comparing the combined arterial patency metric for the first arterial blood supply with the combined arterial patency metric for the second arterial blood supply; and

means for determining the patency of a first artery that provides the first arterial blood supply using a difference between the combined arterial patency metric for the first arterial blood supply and the combined arterial patency metric for the second arterial blood supply.

2. A system as claimed in claim 1, wherein the predetermined function multiplies together at least the first and second arterial blood supply metrics to produce a combined arterial patency metric.

3. A system as claimed in claim 2, wherein the first arterial blood supply metric and the second arterial blood supply metric are normalized before multiplication.

4. A system as claimed in claim 1, wherein the first arterial blood supply metric and the second arterial blood supply metric are different ones of:

arterial blood supply signal strength, arterial blood supply signal caliber, peripheral pulse rate, skin color redness and skin temperature.

5. A system as claimed in claim 1, wherein each probe comprises at least a first sensor and a second sensor, wherein the first sensor provides first output signals used to produce the first arterial blood supply metric and wherein the second sensor provides first output signals used to produce the second arterial blood supply metric and wherein the first and second sensors are different ones of:

a plethysmograph sensor, a skin temperature sensor and a skin color sensor.

6. A system as claimed in claim 1 further comprising signal processing circuitry for processing the output of a sensor into a high frequency signal and a low frequency signal.

7. A system as claimed in claim 6, further comprising means for forming a ratio of the high frequency signal to the low frequency signal.

8. A system as claimed in claim 1, wherein at least one of the first and second probes has a plurality of sensors, the system further comprising means for processing the outputs from the plurality of sensors to select a subset of the plurality of sensors in dependence upon ac components of the outputs from the plurality of sensors and operable subsequently to process the outputs of only the selected subset of sensors to assess blood flow.

9. A system as claimed in claim 8, wherein the selection of a sensor for inclusion in the subset involves calculation of the ratio of ac component to dc component for each sensor.

10. A system as claimed in claim 1, further comprising a probe positioning apparatus comprising:

a three dimensional substrate shaped to conform to a foot;

means for correctly orientating and positioning the substrate adjacent a predetermined portion of a foot when the apparatus is in use;

a first probe location means at a predetermined first location on the substrate such that when the apparatus is in use, the first location is adjacent the first tissue area and the first artery, and

a second probe location means at a predetermined second location on the substrate such that when the apparatus is in use, the second location is adjacent the second tissue area and a second artery.

11. A system as claimed in claim 10, wherein

the three dimensional substrate is invertible such that in a first configuration the substrate is shaped to conform to a left foot and in a second configuration, which is inverted in comparison to the first configuration, the substrate is shaped to conform to a right foot, wherein the means for correctly orientating and positioning the substrate is operable in the first configuration and the second configuration, wherein the first location of the first probe location means is such that when the probe positioning apparatus is in use, the first location is adjacent the same first tissue area of the foot irrespective of whether it is used in the first configuration with the left foot or in the second configuration with the right foot and wherein the second location of the second probe location means is such that when the probe positioning apparatus is in use, the second location is adjacent the same second tissue area of the foot irrespective of whether it is used in the first configuration with the left foot or in the second configuration with the right foot.

12. A system as claimed in claim 10, wherein the first and second arteries are selected from the group comprising:

dorsalis pedis, posterior tibial, plantar and peroneal of the same foot.

13. A system as claimed in claim 10, wherein the first and second tissue areas are selected from the group comprising:

the tibial side of the dorsum of the foot, the inside of the foot beneath the ankle, between the first and second metatarsal bones, the great toe and the heel of the foot.

14. A system as claimed in claim 1, wherein a second artery provides the second arterial blood supply and the first and second arteries are parallel branch arteries from a third artery.

15. A system as claimed in claim 1, wherein a second artery provides the second arterial blood supply and the first artery is a downstream branch of the second artery.

16. A system as claimed in claim 13, wherein the first tissue area is part of a foot and the second tissue area is behind a knee of the same leg.

17. A signal processing unit of a post-operative, arterial patency monitoring system for monitoring patency of an artery of a limb, the unit comprising:

a first input for receiving first input signals from a first probe that are dependent upon a first arterial blood supply to a first tissue area of a limb;

means for processing the first output signals to produce a first arterial blood supply metric for the first arterial blood supply and a second, different, arterial blood supply metric for the first arterial blood supply;

means for using a predetermined function that takes as its arguments at least the first and second arterial blood supply metrics for the first arterial blood supply to produce a combined arterial patency metric for the first arterial blood supply;

a second input for receiving second input signals from a second probe that are dependent upon a second arterial blood supply to a second tissue area of the limb;

means for processing the second output signals to produce a first arterial blood supply metric for the second arterial blood supply and a second, different, arterial blood supply metric for the second arterial blood supply;

means for using the predetermined function that takes as its arguments at least the first and second arterial blood supply metrics for the second arterial blood supply to produce a combined arterial patency metric for the second arterial blood supply;

means for comparing the combined arterial patency metric for the first arterial blood supply with the combined arterial patency metric for the second arterial blood supply; and

means for determining the patency of a first artery that provides the first arterial blood supply using a difference between the combined arterial patency metric for the first arterial blood supply and the combined arterial patency metric for the second arterial blood supply.

18. A unit as claimed in claim 17 further comprising signal processing circuitry for processing the output of a sensor into a high frequency signal and a low frequency signal.

19. A post-operative, arterial patency monitoring method for monitoring patency of an artery of a limb comprising:

positioning a first probe adjacent a first tissue area of a limb fed by a first arterial blood supply such that it produces first output signals that are dependent upon the first arterial blood supply to the first tissue area;

positioning a second probe adjacent a second tissue area of the limb fed by a second arterial blood supply such that it produces second output signals that are dependent upon the second arterial blood supply to the first tissue area;

processing the first output signals to produce a first arterial blood supply metric for the first arterial blood supply and a second, different, arterial blood supply metric for the first arterial blood supply;

combining at least the first and second arterial blood supply metrics for the first arterial blood supply, using a predetermined function that takes as its arguments at least the first and second arterial blood supply metrics for the first arterial blood supply, to produce a combined arterial patency metric for the first blood supply;

processing the second output signals to produce a first arterial blood supply metric for the second arterial blood supply and a second, different, arterial blood supply metric for the second arterial blood supply;

combining at least the first and second arterial blood supply metrics for the second arterial blood supply, using the predetermined function that takes as its arguments at least the first and second arterial blood supply metrics for the second arterial blood supply, to produce a combined arterial patency metric for the second arterial blood supply;

comparing the combined arterial patency metric for the first arterial blood supply with the combined arterial patency metric for the second arterial blood supply; and

determining the patency of a first artery that provides the first arterial blood supply using a difference between the combined arterial patency metric for the first arterial blood supply and the combined arterial patency metric for the second arterial blood supply.

20. A post-operative, arterial patency monitoring system for monitoring patency of an artery of a limb comprising:

a first probe positioned adjacent a first tissue area of a limb for producing first output signals dependent upon a first arterial blood supply to the first tissue area;

means for processing the first output signals to produce a first arterial blood supply metric for the first arterial blood supply and a second, different, arterial blood supply metric for the first arterial blood supply;

means for using a predetermined function that takes as its arguments at least the first and second arterial blood supply metrics for the first arterial blood supply to produce a combined arterial patency metric for the first arterial blood supply;

means for determining the patency of a first artery that provides the first arterial blood supply using the combined arterial patency metric for the first arterial blood supply.

21. A system as claimed in claim 20, integrated within a substrate for attachment to a limb further comprising a visual indicator for the patency of the first artery.

22. A system as claimed in claim 21, further comprising means for converting heat from the limb to electrical energy for powering the system.

23. A system as claimed in claim 20, wherein the predetermined function multiplies together at least the first and second arterial blood supply metrics to produce a combined arterial patency metric.

24. A system as claimed in claim 23, wherein the first arterial blood supply metric and the second arterial blood supply metric are normalized before multiplication.

25. A system as claimed in claim 20, wherein the means for determining a change in the patency of the first artery determines a change with time of the combined arterial patency metric for the first arterial blood supply.

26. A system as claimed in claim 20, wherein the means for determining a change in the patency of the first artery determines a change in the combined arterial patency metric for the first arterial blood supply compared to a combined arterial patency metric for a second arterial blood supply.

27. A system as claimed in claim 20, wherein the first arterial blood supply metric and the second arterial blood supply metric are different ones of:

arterial blood supply signal strength, arterial blood supply signal caliber, peripheral pulse rate, skin color redness and skin temperature.

28. A system as claimed in claim 20 further comprising signal processing circuitry for processing the output of a sensor into a high frequency signal and a low frequency signal.

29. A post-operative, arterial patency monitoring method comprising:

positioning a first probe adjacent a first tissue area of a limb such that it produces first output signals dependent upon a first arterial blood supply to the first tissue area;

processing the first output signals to produce a first arterial blood supply metric for the first arterial blood supply and a second, different, arterial blood supply metric for the first arterial blood supply;

combining the first and second arterial blood supply metrics for the first arterial blood supply to produce, using a predetermined function that takes as its arguments at least the first and second arterial blood supply metrics for the first arterial blood supply, a combined arterial patency metric for the first arterial blood supply; and

determining the patency of a first artery that provides the first arterial blood supply using the combined arterial patency metric for the first arterial blood supply.

30. A self-contained post-operative, arterial patency monitoring system integrated within a substrate for attachment to a tissue area of a limb comprising:

a first probe for producing output signals dependent upon an arterial blood supply to the tissue area of the limb to which the substrate is attached;

means for processing the output signals to produce a first arterial blood supply metric for the first arterial blood supply and a second, different, arterial blood supply metric for the first arterial blood supply; and

visual indication means that indicate arterial perfusion of the tissue area, arranged to be driven in dependence upon the first and second arterial blood supply metrics.

31. A self-contained system as claimed in claim 30, wherein the first arterial blood supply metric is a peripheral pulse rate and the frequency of illumination of the visual indication means is dependent upon the peripheral pulse rate.

32. A self-contained system as claimed in claim 30, wherein the second arterial blood supply metric is one of:

arterial blood supply strength, arterial blood supply caliber, skin color redness and skin temperature and the magnitude of illumination of the visual indication means is dependent upon the second arterial blood supply metric.

33. A self-contained system as claimed in claim 30, wherein the visual indication means is arranged to be driven in dependence upon an arterial patency metric created from the combination of the first and second arterial blood supply metrics.